毕业论文--结肠镜下结肠、直肠息肉238 例治疗临床分析.doc

结肠镜下结肠、直肠息肉238 例治疗临床分析 作者：黄志刚 刘有理 王义文 王光明 邓衍部 贺道兴 周政 朱明 【摘 要】目的 分析电子肠镜直视下高频电切、电凝结合微波探头治疗结、直息肉的疗效,探讨结、直息肉内镜治疗手段。方法 对238 例326 枚结、直息肉经电子肠镜下高频电切、电凝结合微波探头治疗的疗效进行分析，其中术前病理证 实腺瘤性息肉169 枚，炎性息肉130 枚，幼年性息肉27 枚，均成功治疗，未发生严重并发症，切下大体标本能取出者亦均有病理证实，2 例术后2 枚切下息肉大体标本病理证实灶性癌变，术后外科再行根治手术。结论 电子肠镜下高频电切、电凝结合微波探头治疗结、直息肉安全，疗效可靠，是治疗结、直息肉的最佳方法。 【关键词】结、直肠息肉；腺瘤性息肉；电切电凝；微波；内镜下治疗 [Abstract] Objective To analyze the effect of high frequency power cut or coagulation combine microwave probe under electric colonoscopy direct vision of treating colon and rectum polyp, discussion the measure of endoscopy treat of colon and rectum polyp. Methods To analyze the treat effect of 326 knots in 238 cases of colon and rectum polyps combine high frequency power cut or coagulation and microwave probe under electric colonoscopy. By preoperative pathology , 169 cases of which were confirmed adenomatous polyps, 130 cases were inflammatory polyps, 27 cases were young polyps, which were treated successfully without serious complications, the gross specimen which can be cut out were all pathology confirmed, 2 knots in 2 cases of the gross specimen of polyps after operation confirmed focal cancer, which were surgical operationed after operation. Conclusion Combining high frequency power cut or coagulation and microwave probe under electric colonoscopy, which were safe, the effect were reliable, it is the best method to treat the colon and rectum polyps.[Keywords] Colorectal polyps; Adenomatous polyp; Transurethral electric coagulation; Microwave; Endoscopic therapy 2005 年1 月2010 年11 月我院电子肠镜检查患者共3028 例，检出结、直息肉238 例共326 枚，并行肠镜下高频电切、电凝结合微波治疗，2 例术后切下大体标本病理示灶性癌变，转外科行根治术，所有治疗病例无严重并发症发生，提示肠镜下高频电切、电凝、结合微波治疗结、直肠息肉安全可靠，创伤小、费用低、疗效确切。 1 临床资料和方法 1.1 临床资料 自2005 年1 月至2010 年11 月，我院消化内科、内镜室门诊及住院患者行电子结肠镜检查3028例，检出结、直肠息肉238 例，息肉326 枚，其中男性患者128 例，女性患者110 例，年龄3～85 岁。息肉单发168 例，多发70 例。直肠息肉168 例，息肉232 枚，乙状结肠息肉36 例，息肉54 枚，降结肠（含乙降交界）18 例，息肉22 枚，横结肠、升结肠16 例，息肉18 枚。总计息肉单发168 例，多发70 例，最多一例9 枚。息肉大小：直径大于2cm 息肉18 枚，直径1～2cm 息肉32 枚，0.5～